phase ii study of ofatumumab plus ifosfamide, carboplatin, etoposide (ice) or dexamethasone, cytarabine, cisplatin (dhap) chemotherapy regimen in relapsed/ refractory diffuse large b cell lymphoma (dlbcl)

Conditions: Lymphoma, Large-Cell, Diffuse

Summary: the purpose of this study is to evaluate the safety and efficacy of ofatumumab used in combination with ifosfamide, carboplatin, etoposide (ice) or dexamethasone, cytarabine, cisplatin (dhap) salvage chemotherapy regimens in subjects with relapsed or refractory diffuse large b cell lymphoma (dlbcl) who are eligible for autologous stem cell transplant.

rituximab combined with anthracycline based chemotherapy is the most common first-line treatment for subjects with diffuse large b cell lymphoma (dlbcl). subjects requiring second-line therapy will most often receive rituximab in combination with salvage chemotherapy as an induction therapy prior to autologous stem cell transplant. with rituximab being in first-line therapy, the response rates for subjects receiving rituximab plus salvage chemotherapy has significantly decreased. treatment with ofatumumab may be able to overcome the resistance to rituximab in the second-line setting and offer improved response rates. the objective of this study is to evaluate the overall response rate of ofatumumab in combination with ice or dhap chemotherapy prior to autologous stem cell transplant. additional objectives are to evaluate the complete response rate, ability to mobilize cluster of differentiation (cd)34+ cells, progression-free survival (pfs) and overall survival.

Eligibility criteria:
inclusion criteria: * subjects with cd20 positive aggressive non-hodgkin's lymphoma (nhl) including dlbcl, transformed follicular lymphoma (fl) \& grade 3b fl. refractory to, or relapsed following, first-line treatment with rituximab combined with anthracycline- or anthracenedione-based chemotherapy as defined by the protocol. * computed tomography (ct) with involvement of 2 or more clearly demarcated lesions with a long axis \> 1.5 centimeters (cm) and short axis ≥ 1.0 cm or 1 clearly demarcated lesion with a long axis \>2.0 cm and short axis ≥1.0 cm. * baseline \[18f\] fluorodeoxyglucose (fdg)-positron emission tomography (pet) scans must demonstrate positive lesions compatible with ct defined anatomical tumor sites. * age 18 yrs or older. * eastern cooperative oncology group (ecog) performance status of 0, 1 or 2. * eligible for high dose chemotherapy and autologous stem cell transplant (asct). * resolution of toxicities from first-line therapy to a grade that in the opinion of the investigator does not contraindicate study participation. * signed written informed consent. exclusion criteria: * previous cancer therapy for lymphoma, with the exception of required rituximab/ anthracycline- or anthracenedione-based chemotherapy, monotherapy rituximab prior to first-line therapy and / or as a maintenance therapy, or limited field radiotherapy (as defined by the protocol). * any anti-cancer therapy, except limited field radiotherapy, within 2 weeks prior to start of study therapy. * chronic glucocorticoid use (limited acute use is allowed and defined by the protocol). * history of significant cerebrovascular disease. * abnormal/ inadequate white blood cell (wbc) count, liver, and kidney function. * clinically significant cardiac disease, active or chronic infections, serious significant diseases, other cancer within last 5 years. * known or suspected hypersensitivity to study treatments. * prior treatment with anti-cd20 monoclonal antibodies, at any time, or treated with other monoclonal antibodies within 3 months prior to start of study therapy, with the exception of rituximab in both instances. * inability to comply with the protocol activities. * pregnant or lactating women or female patients of child-bearing potential (or male patients with such partners) not willing to use adequate contraception during and up to 1 year following dosing completion.

Keywords: salvage chemotherapy relapsed grade 3b follicular lymphoma efficacy safety dhap ofatumumab refractory non-hodgkin's lymphoma diffuse large b cell lymphoma (dlbcl) oncology ice transformed follicular lymphoma